The view provided by ___ scanning helps make invasive tests, such as ___, safer.

ultrasound

amniocentesis

Using ___, an examiner can evaluate fetal structure and growth; the placenta; the quantity of amniotic fluid; maternal structures; the biochemical status of tissues and organs; and soft-tissue, metabolic, and functional anomalies.

The ___ is the most widely used technique for ___ evaluation of the fetus.

nonstress test

antepartum

A woman who is at 36 weeks of gestation is having a nonstress test. Which statement by the woman would indicate a correct understanding of the test?

A. “I will need to have a full bladder for the test to be done accurately.”
B. “This test will help to determine whether the baby has Down syndrome or a neural tube defect.”C. “This test will observe for fetal activity and an acceleration of the fetal heart rate to determine the well-being of the baby.”
D. “I should have my husband drive me home after the test because I may be nauseous.”

C. “This test will observe for fetal activity and an acceleration of the fetal heart rate to determine the well-being of the baby.”

(this multiple choice question has been scrambled)

The ___ is one of the most widely used techniques to determine fetal well-being and is accomplished by monitoring ___ in conjunction with ___ and ___.

nonstress test

fetal heart rate

fetal activity and movements

An ultrasound OR a nonstress test is the test that requires a full bladder.

ultrasound

A pregnant woman should be driven home after having an ___ test.

amniocentesis

A nonstress test may OR should notcause nausea.

should not

A ___ is used in conjunction with ___, and ___ helps to determine the presence of ___.

maternal alpha-fetoprotein test

unconjugated estriol levels

human chorionic gonadotropin

Down syndrome

Which choice gives indicators for performing a contraction stress test?

Decreased fetal movement is an indicator for performing a ___; the size (small for gestational age) is OR is notan indicator.

contraction stress test

is not

Indications for performing a contraction stress test

Maternal diabetes mellitus

Postmaturity

Decreased fetal movement

Intrauterine growth restriction

History of a previous stillbirth

T/F: Adolescent pregnancy and poor prenatal care are risk factors of poor fetal outcomes and are indicators for performing a contraction stress test.

are not indicators

The nurse sees a woman for the first time when she is 30 weeks pregnant. The woman has smoked throughout the pregnancy, and fundal height measurements now are suggestive of growth restriction in the fetus. In addition to ultrasound to measure fetal size, what would be another tool useful in confirming the diagnosis?

A biophysical profile would be a method of biophysical assessment of fetal well-being in the ___.

third trimester

An amniocentesis is performed ___ week of pregnancy.

after the fourteenth

MSAFP belownormal is associated with

Down syndrome

Trisomy 18

Diabetic patients also have lower levels.

MSAFP abovenormal is seen in

Multiple gestation

Placental abruption

Neural tube defects

including spina bifida

anencephaly

abdominal wall defects

What is a "MSAFP" test?

Maternal serum AFP (MSAFP) varies by orders of magnitude during the course of a normal pregnancy. MSAFP increases rapidly until about 32 weeks gestation, then decreases gradually. After the pregnancy ends it decreases rapidly, with a half-life of about 5 days.

It entails sampling of the chorionic villus (placental tissue) and testing it for chromosomal abnormalities, usually with FISH or PCR. CVS usually takes place at 10–12 weeks' gestation, earlier than amniocentesis or percutaneous umbilical cord blood sampling. It is the preferred technique before 15 weeks.

UPI

Uteroplacental insufficiency - decline in placental function (exchange of gases, nutrients, and wastes) leading to fetal hypoxia and acidosis; evidenced by later decelerations.

What is a "biophysical profile"?

Noninvasive ultasonography.

An MSAFP (Maternal serum alpha-fetoprotein) test is performed from ___ of the gestation (___ are ideal).

week 15 to week 22

weeks 16 to 18

Nurses should be aware of the strengths and limitations of various biochemical assessments during pregnancy, including that:

A. Chorionic villus sampling (CVS) is becoming more popular because it provides early diagnosis.
B. Screening for maternal
serum alpha-fetoprotein (MSAFP) levels is recommended only for women at risk for
neural tube defects.
C. Percutaneous umbilical blood sampling (PUBS) is one of the triple-marker tests for Down syndrome.
D. MSAFP is a screening tool only; it identifies candidates for more definitive procedures.

D. MSAFP is a screening tool only; it identifies candidates for more definitive procedures.

Chorionic villus sampling (CVS) does provide ___, but it is declining in popularity because of advances in noninvasive screening techniques.

a rapid result

T/F: Screening for maternal serum alpha-fetoprotein (MSAFP) levels is recommended only for women at risk for neural tube defects.

F: MSAFP screening is recommended for all pregnant women.

T/F: Percutaneous umbilical blood sampling (PUBS) is one of the triple-marker tests for Down syndrome.

F: MSAFP, not PUBS, is part of the triple-marker tests for Down syndrome.

The nurse providing care for the antepartum woman should understand that the contraction stress test (CST):

A. Is considered negative if no late decelerations are observed with the contractions.
B. Sometimes uses vibroacoustic stimulation.
C. Is an invasive test; however, contractions are stimulated.
D. Is more effective than the nonstress test (NST) if the membranes have already been ruptured.

A. Is considered negative if no late decelerations are observed with the contractions.

F: Vibroacoustic stimulation is sometimes used with the NST (nonstress test).

The CST is invasive if stimulation is by ___ but not if by ___.

intravenous oxytocin

nipple stimulation

T/F: The CST is contraindicated if the membranes have ruptured.

True

In the past factors to determine whether a woman was likely to develop a high risk pregnancy were evaluated primarily from a medical point of view. A broader, more comprehensive approach to high risk pregnancy has been adopted today. There are now four categories based on threats to the health of the woman and the outcome of pregnancy. These categories include all of the following except:

A. Psychosocial.
B. Environmental.
C. Biophysical.D. Geographic.

D. Geographic.

(this multiple choice question has been scrambled)

Biophysical is one of the broad categories used for determining risk. These include ___, ___, and ___.

genetic considerations

nutritional status

medical and obstetric disorders

Psychosocial risks include ___. All of these adverse lifestyles can have a negative effect on the health of the mother or fetus.

smoking

caffeine

drugs

alcohol

psychologic status

Sociodemographic risks stem from the mother and her family. ___ may be one of the risks to pregnancy; however, it is not the only factor in this category. ___, ___, ___, ___ and ___ are also included.

Ethnicity

Low income

lack of prenatal care

age

parity

marital status

Environmental risks are those that can affect both ___ and ___. These include ___ (X6).

fertility

fetal development

infections

chemicals

radiation

pesticides

illicit drugs

industrial pollutants

MSAFP levels have been used as a screening tool for ___ in pregnancy.

neural tube defects

All Rh-negative mothers get ___ administered ___ within ___ hours after birth of a ___. This is to ___. All Rh-negative mothers get the same drug after ___ and ___.

RhoGAM

intramuscularly

72

Rh-positive baby

prevent sensitization, i.e. mom creating antibidoes

amniocentesis

CVS

There are usually ___ in the umbillical cord and only ___. The ___ is the largest of these vessels.